The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the Oregon Medicaid Income Limits for 2021. Medicaid in Oregon is also called Oregon Health Plan.
Based on this information, you will be able to determine whether your income qualifies you for Oregon Medicaid or not.
However, before we get into details about the income limit, we will first explain the Medicaid program in Oregon and how it works.
Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
How Many People are on Medicaid?
According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:
- 78,521,263 individuals were enrolled in Medicaid and CHIP
- 72,204,587 individuals were enrolled in Medicaid
- 6,695,834 individuals were enrolled in CHIP
Oregon Medicaid
The Oregon Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 1.1 million people.
This includes 444,000 children as shown by the image below.
In Oregon, Medicaid is also called the Oregon Health Plan (OHP) and is administered by the Oregon Health Authority (OHA).
Who Can Get Medicaid in Oregon?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
Oregon Medicaid Income Limit
The Oregon Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the Oregon Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2021.
| 2021 Federal Poverty Levels for the 48 Contiguous States & D.C. | |||
| Household Size | Poverty Guideline for 48 states & DC | Alaska | Hawaii |
| 1 | $12,880 | $16,090 | $14,820 |
| 2 | $17,420 | $21,770 | $20,040 |
| 3 | $21,960 | $27,450 | $25,260 |
| 4 | $26,500 | $33,130 | $30,480 |
| 5 | $31,040 | $38,810 | $35,700 |
| 6 | $35,580 | $44,490 | $40,920 |
| 7 | $40,120 | $50,170 | $46,140 |
| 8 | $44,660 | $55,850 | $51,360 |
| Over 8 people | add $4,540 for each additional person | $5,680 | $5,220 |
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 185 percent of FPL
- Any child age 1-5 with a family income up to 133 percent of FPL
- Children ages 6- 18 with family income up to 133 percent of FPL
- CHIP for children with family income up to 300 percent of FPL
- Pregnant women with family income up to 185 percent of FPL
- Parents of minor children with family income up to 38 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL
- Adults without dependents under Medicaid expansion with income up to 133% of the FPL
Oregon Medicaid Income Limit Charts
The Oregon Medicaid eligibility income limit charts are divided by groups.
For example, the first chart is focused on income limits for children who qualify for Medicaid.
Similarly, the second chart below focuses on the Medicaid income limits for adults in Oregon who qualify for Medicaid.
Oregon Medicaid Income Limit for Children
Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.
| Oregon Medicaid Income Limit – Children | ||||||
| Children Medicaid Ages 0-1 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 185% | 133% | 133% | 300% | |
|
Household Size
|
1 | $12,880 | $23,828 | $17,130 | $17,130 | $38,640 |
| 2 | $17,420 | $32,227 | $23,169 | $23,169 | $52,260 | |
| 3 | $21,960 | $40,626 | $29,207 | $29,207 | $65,880 | |
| 4 | $26,500 | $49,025 | $35,245 | $35,245 | $79,500 | |
| 5 | $31,040 | $57,424 | $41,283 | $41,283 | $93,120 | |
| 6 | $35,580 | $65,823 | $47,321 | $47,321 | $106,740 | |
| 7 | $40,120 | $74,222 | $53,360 | $53,360 | $120,360 | |
| 8 | $44,660 | $82,621 | $59,398 | $59,398 | $133,980 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
Oregon has expanded Medicaid to include adults without dependents.
Therefore, adults without dependents can apply for Medicaid in Oregon.
For an update on the Medicaid expansion debate and timeline in Oregon, see our Oregon Expansion update below.
Oregon Medicaid Income Limit for Adults
| Oregon Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 185% | 38% | 74% | 133% | |
|
Household Size
|
1 | $12,880 | $23,828 | $4,894 | $9,531 | $17,130 |
| 2 | $17,420 | $32,227 | $6,620 | $12,891 | $23,169 | |
| 3 | $21,960 | $40,626 | $8,345 | $16,250 | $29,207 | |
| 4 | $26,500 | $49,025 | $10,070 | $19,610 | $35,245 | |
| 5 | $31,040 | $57,424 | $11,795 | $22,970 | $41,283 | |
| 6 | $35,580 | $65,823 | $13,520 | $26,329 | $47,321 | |
| 7 | $40,120 | $74,222 | $15,246 | $29,689 | $53,360 | |
| 8 | $44,660 | $82,621 | $16,971 | $33,048 | $59,398 | |
How to Read the Oregon Medicaid Income Limits Charts Above
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 185% of the Federal Poverty Level – which for a family of two is $32,227 as shown in the chart above.
How to Apply for Oregon Medicaid
There are 2 ways you can apply for Medicaid in Oregon.
Option 1 – Apply online
You can apply online through the one.oregon.gov Portal – as shown in the image below.
If you have an account, you can log in or create your one.oregon.gov account. Click here to be taken to the website.
The video below, from the Oregon Health Authority, does a great job of walking you through how to apply for Medicaid online.
We highly encourage you to watch it if you are planning to apply for OR Medicaid online.
Option 2 – Download Application
You can download an application, complete it, and mail it to your county DHS office or submit it in person.
Additionally, you can request a paper application by calling OHP Customer Service at 1-800-699-9075 or 711 (TTY).
Mail applications to:
OHP Customer Service
P.O. Box 14015
Salem, OR 97309-5032
OHP Fax number: 503-378-5628
Oregon Medicaid Phone Number
Here’s how to contact the Oregon Medicaid Agency:
For Medicaid Applicant & Member Services
Call the Oregon Health Plan (OHP):
Application questions: 800-699-9075 (toll-free)
Coverage questions: 800-273-0557 (toll-free)
Oregon Medicaid Expansion Update
Oregon Medicaid is a longstanding national leader in making health insurance available to residents via its Medicaid program.
The Oregon legislature passed approved Medicaid expansion under the ACA in early in 2014.
It was estimated that Oregon would enroll 400,000 new members in the Medicaid program by 2022 as part of Medicaid expansion.
In the fall of 2013, prior to the launch of the ACA’s exchanges, Oregon’s total Medicaid/CHIP enrollment stood at more than 626,000.
By March 2016, enrollment in Oregon Medicaid/CHIP was 1,076,961.
That is a 72 percent increase compared to 2013 enrollment.
This growth in Medicaid enrollment, at the time, was tied with Colorado for the third-highest percentage growth in the country, behind only Kentucky and Nevada.
Oregon Medicaid Income Limits Summary
We hope this post on Oregon Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of Oregon, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
Alabama Medicaid Income Limits and How to Apply
Alaska Medicaid Income Limits and Chart
Pennsylvania Medical Assistance CHIP Income Limits